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Effect of Phlebotomy and pH on Iron Absorption from the Colon

Donner Laboratory and Donner Pavilion, University of California, Berkeley, California

Correspondence: For reprints contact: H. S. Winchell, Donner Laboratory and Donner Pavilion, University of California, Berkeley, Calif. 94720.

ABSTRACT

Colonic absorption of iron in dogs may be of sufficient magnitude to account for a large component of the iron absorbed during the slow phase (after the first 2 hr following administration) of intestinal iron absorption. In the present experiments phlebotomy resulted in a threefold increase in iron absorption when the iron was administered directly into the duodenum whereas it caused a seven- to ten-fold increase in colonic absorption when the iron was administered directly into the colon. Following phlebotomy when the pH of the iron introduced into the colon was low (pH 2), essentially all of the iron absorbed into the body occurred within the first 2 hr. When the pH was elevated (pH 6), only a third of the iron absorbed from the colon into the body occurred during the first 2 hr, the remaining two thirds being absorbed subsequent to this time. It is suggested that the rapid or slow phase of intestinal iron absorption may be thought of as related to the relative pH of the iron at the time iron absorption is occurring rather than with regard to location in specific anatomical sites. The significant colonic absorption of iron following phlebotomy in the present experiments suggests the possible use of colonic iron administration in the treatment of iron deficiency secondary to blood loss.